Abstract
While medicine has made remarkable advances in transplant procedures, there remains a large void of acceptable tissue and organ replacements or substitutes. When autologous tissues are unavailable, synthetic grafts, made out of polytetrafluoroethylene (PTFE or Gore-Tex®) or polyethylene terephthalate (PET or Dacron®), are commonly used. While these nondegradable conduits can be successful in large diameter (>6 mm) operations, they are often susceptible to infection, thrombosis, stenosis, and ectopic calcification. Furthermore, somatic overgrowth is often an issue in the pediatric patient population as these grafts lack growth capacity. Congenital cardiac anomalies are the leading cause of death in the newborn period and affects approximately 1% of all live births. For the nearly one-quarter of congenital heart defect patients that will require major reconstructive surgery, a better alternative is needed.
Tissue engineering is a relatively new scientific field and originally came to the forefront of medicine to address the pervasive shortage of donor tissue and organs. The classic tissue engineering paradigm consists of seeding cells or cellular substitutes on a tissue inducing scaffold. Using this model, the first human TEVG implantation procedure was performed in 1999. Here we take a look at the engineering and biological considerations in vascular medicine and provide background that lead to the current clinical trial investigating the use of tissue-engineered vascular grafts (TEVGs) in congenital heart surgery.
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Shoji, T., Breuer, C., Shinoka, T. (2020). Tissue-Engineered Vascular Grafts for Children. In: Walpoth, B.H., Bergmeister, H., Bowlin, G.L., Kong, D., Rotmans, J.I., Zilla, P. (eds) Tissue-Engineered Vascular Grafts. Reference Series in Biomedical Engineering(). Springer, Cham. https://doi.org/10.1007/978-3-030-05336-9_19
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